A comparison of outcomes of asymmetry in infants with congenital muscular torticollis according to age upon starting treatment.
KyeongSoo Lee, EunJung Chung, Byoung-Hee Lee
PMID 28356651WHAT IT FOUND
Infants with congenital muscular torticollis who began ultrasound, massage, manual stretching and passive stretching before six weeks had a larger reduction in sternocleidomastoid thickness difference than those starting later.
Head tilt and overall scores improved too. No single component can be credited.
Key findings
01The sternocleidomastoid thickness difference was the only outcome reported to differ between the age groups after treatment.
02The reported change in sternocleidomastoid thickness difference was 3.9 mm for infants starting before six weeks and 2.5 mm for infants starting after six weeks.
03Infants received therapeutic ultrasound, massage therapy, manual stretching exercises and passive stretching exercises together, so the contribution of any single component cannot be separated.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The infants were grouped by age at treatment start rather than randomly assigned, so baseline differences may explain the between-group result. All infants received ultrasound, massage, manual stretching and passive stretching together, so the contribution of any single component cannot be separated. There was no untreated control group, so the changes cannot be compared with infants who received no treatment. The paper does not report how long treatment continued or what happened after treatment ended. Blinding of therapists, parents or outcome assessors is not reported, and the torticollis overall assessment included subjective parent reports.
The easy way to misread this
Do not conclude that starting any treatment before six weeks will cause a better outcome. The study did not randomise infants, all infants received several treatments together, and only the sternocleidomastoid thickness difference was reported as different between the age groups after treatment.